Published October 26, 2020

Understanding Scleroderma

A rheumatologist strives to help patients with joint and connective tissue disorders have a better quality of life.

Vivien Hsu is a rheumatologist and expert on connective tissue diseases. Her areas of expertise include scleroderma and related connective tissue diseases, rheumatoid arthritis, and psoriatic arthritis.

photo of vivien hsuRheumatism describes any painful disorder in the joints, muscles, or connective or soft tissues around joints and bones, including arthritis, gout, and systemic lupus, as well as scleroderma, which may be caused by overactive autoimmune system. Scleroderma causes a hardening of the skin and connective tissues and, in about one-third of cases, also impacts blood vessels and the heart, lungs, and kidneys. It is a complex and difficult-to-diagnose disease, and patients may search for years before getting an accurate diagnosis and treatment plan.

“Unusual, very different symptoms can send undiagnosed patients bouncing from one doctor to another and wondering what is causing their pain,” says Hsu NCAS’78, NJMS’83. “You have to know a lot about internal medicine, about every organ that is affected by these different rheumatic diseases. Most, like scleroderma, have no cures but we can offer a lot to control the disease.”

Hsu is one of only a few dozen scleroderma specialists in the United States. She directs the Rutgers Scleroderma Program, part of the university’s Division of Rheumatology and Connective Tissue Research, which has achieved national and international recognition for clinical care and research.

The W.H. Conzen Chair in Clinical Pharmacology was established by the Schering-Plough Foundation in honor of its late chairman and chief executive.

In the Professor’s Own Words

Why did you choose to specialize in rheumatology?

The rheumatic diseases are fascinating. No two patients with the same diagnosis are alike and just when you think you have the answer, the patient changes over time!

What achievements are you proudest of?

We have learned so much about scleroderma, including the disease’s course, how to measure changes as the disease changes, and how improved management and earlier intervention have clearly improved quality of life for our patients.

What is most fulfilling about your work?

Seeing our patients feel better and live longer with our interventions. The extra time spent in counseling our patients improves their understanding of their disease, compliance with their medications, and trust so that they are willing to participate in clinical trials of novel therapies, sometimes “first in man,” to bring better treatment to future generations with this disease.

What aspect of your work is the most frustrating?

Exorbitantly high costs of new drugs, insurance denials for the simplest things. Or the need to appeal anything—treatments or tests—that our patients need.


This story is part of Rutgers University Foundation’s Endowed Chairs Impact series. Supporting professorships and research helps spark innovation and creativity here in New Jersey and beyond. 

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